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19 March, 2018 00:00 00 AM

Skin cancers

Dr Wrishi Raphael
Skin cancers

Although skin cancers are not very common in Bangladesh, the effects of climate change have galvanized the incidence of such disorders around the world. According to WHO, between 2 and 3 million non-melanoma skin cancers and 132,000 melanoma skin cancers occur globally each year. As ozone levels are depleted, the atmosphere loses more and more of its protective filter function and more solar UV radiation reaches the Earth's surface. It is estimated that a 10 per cent decrease in ozone levels will result in an additional 300,000 non-melanoma and 4,500 melanoma skin cancer cases.

Squamous Cell Carcinoma (SCC) of the skin occurs from keratinocytes (cells of the outermost layer of the skin). Ultraviolet rays of the sun are the commonest cause of squamous cancers.

Such cancers of the mouth may also be caused by smoking, spirits, spices and Syphilis. Betel leaves and betel nuts – used as mouth fresheners in the Indian subcontinent is a risk factor for SCC.SCC is most common cutaneous malignancy organ transplant recipients.

Squamous Cell Cancer occurs in sun-exposed areas mostly the hands, forearms, anterior aspect of thighs, scalp (baldness is a risk factor) and lower lips.

Squamous cell carcinomas detected at an early stage and removed promptly are almost always curable and cause minimal damage. The Mohs skin surgery technique is the most efficacious treatment for squamous cell cancer, in which the lesion is surgically excised and surrounding tissue examined thoroughly for traces of cancer. Other treatment options include electro surgery, cryosurgery and radiation.

Basal Cell Carcinoma

Basal cell skin tumour is the commonest skin tumour in Australia. 80% of the patients are men and there is increased incidence among fair skinned people. This cancer also occurs on the sun exposed areas of the body including the face, neck, upper trunk and limbs.

This cancer grows very slowly and is not associated with the production of keratin scales. The lesion may be described as a pearly papule or nodule – more obvious if we pull the edges of the skin around the tumour. The surface of the tumour often sloughs out to form ulcers. Although there is no metastasis of basal cell carcinoma, the tumour spreads locally.

The treatment options for basal cell skin cancer is similar to squamous cell tumours, the commonest being Mohs surgery. Radiotherapy and photodynamic therapy may be helpful if surgery is not possible.

Melanoma

Melanoma is one of the commonest cancers of first world countries and it has malignant potential. Early diagnosis and treatment is of paramount importance. Poor prognostic features are summarised below:

Deeper the melanoma, worse the prognosis.

Certain sites especially the head, neck and trunk have been associated with worse prognosis.

Male patients aged beyond 50 years usually succumb to this condition then other patients

Amelanocytic melanoma is a common yet easily misdiagnosed variety of melanoma because the lesion is not as dark or well demarcated as the other varieties of melanoma

If lymphnodes are enlarged it is usually because the disease has spread beyond the confines of the skin.

Melanoma is known to spread to liver, lungs, brain and bowel. Excision of the tumour along with several millimetres of healthy skin remains the mainstay of treatment till date. If the tumour has spread to distant organs the more conventional modes of cancer therapy needs to be used. (Reprint)

 

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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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